If no germ is found during the ultrasound examination on the 40th day of pregnancy, it can be divided into the following cases: Firstly, the patient’s menstruation is irregular and is regularly delayed backwards, for a few days or more than 10 days. As the menstrual cycle lengthens, ovulation will also be delayed, and the fertilized egg will not have settled by the 40th day of pregnancy, so the ultrasound examination will not find the gestational sac and germ. In the second case, if the patient has regular menstruation, neither early nor late, but no germ is found during the ultrasound examination at 40 days of pregnancy, it is necessary to be alert and focus on the bilateral adnexal area to see if there is an embryonic sac or germ to exclude ectopic pregnancy. In the third case, the patient has a hypoplastic gestational sac. If the gestational sac is found alone and no germ is found inside, continuous observation can be performed. If no germ is found at 50 days of observation, the patient is then advised to take blood tests to help the doctor make a diagnosis.